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In Practice: The Physician’s Guide to the Internet
Where should you turn for credible health information on the Web?
By Shirley Grace

In late 2006, the World Wide Web topped 100 million distinct Web sites. So reported Netcraft, an Internet services company dedicated to tracking Internet usage. Just a year later that count had grown by nearly half to 142 million, and currently the Web is expanding at a rate of about 5 percent a month.

Who uses the Internet? That answer varies widely across the world, but in North America, nearly everyone. Despite comprising just 5 percent of the world’s current population of 6.6 billion, we’re responsible for 18 percent of the world’s Internet usage. On any given day, three out of four North Americans regularly hop online for a multitude of reasons, including, of course, access to health information.

Certainly, as a physician you’re finding more and more reasons to log on in support of your practice. You use Web-based billing or EMR services. You check insurance benefits. You make sure you’re complying with health regulations. You research diseases and recommend treatments. And more, much more.

Your patients are online, too. They’re investigating their symptoms on WebMD, Healthline.com, or other similar sites and in some cases self-diagnosing. They may be regularly bringing you printouts about conditions and drugs they are reading about online. Some look promising, others less so — as far as you can tell in the few minutes you’ve got to peruse the information.

Likely, you’ve got a few links from your practice’s Web site directing patients to various Web sites for additional health information. But it’s also important to talk to your patients about evaluating the health information they find online. So the more educated you are about how and where to find legitimate Web sources, the better you’ll be able to educate your patients.

Notably, no single entity owns the Internet in its entirety (although it is overseen and standardized by a number of organizations, including the National Science Foundation, the Internet Engineering Task Force, ICANN, InterNIC, and the Internet Architecture Board).

So how do you truly know what’s reliable information and what’s bogus — for your practice, your patients, and yourself? Not easily. Even back in 2001, when significantly less information occupied cyberspace, the late ABC news anchor Peter Jennings said during a Larry King Live interview: “My one great concern about the Internet — and I use it religiously, it’s the most enormously potent research tool — but I’m never quite sure if I’m talking to a goat. And that does make me a little nervous at times.”

The good news is that there are methods for checking out a Web source that can give you more peace of mind about the legitimacy and accuracy of Web sites you’re using and directing your patients to. Read on for a few tips in this regard, and a useful listing of helpful and dependable Web sites.

As a matter of fact

A Web site whose information is clearly backed up by scientific evidence scores highly in terms of reliability. “Peer-reviewed is a good catchword,” says Chuck Heidenrich, practice manager for Tucson, Ariz.-based Aung Foot Clinics.

The information presented must show that it’s supported by both an evidence-based process — legitimate research using established scientific methodologies and resulting in an unambiguous outcome — and the backing of multiple experts in that field, and “not just someone’s idea that it’s ‘cool,’” says Heidenrich.

Every single one of the 19 Web sites listed as links on Aung Foot Clinic’s Web site clearly delineates where its facts are derived from — including commercial vendors such as Hodgson Mill, which manufactures whole grain and organic foods. Aung Foot Clinic even accesses Internet information in the exam room with the patient. Access to information is tied to the patient’s record in the practice’s EMR. That way, doctor and patient can quickly tap into information that backs up a diagnosis and proposed treatment plan. “It offers us an opportunity to have a dialogue with patients,” says Heidenrich.

He believes this interaction is critical to the success of their treatments: “We need them to ‘sign on,’” he says, both in terms of the Internet and treatment compliance. When a patient sees that a piece of research is clearly evidence-based, this is more likely to occur. Does it work? Well, Aung Foot Clinics claims that its patient compliance rate runs higher than 80 percent.

Stamp of approval

“With healthcare providers, there’s a bit of a gap in understanding the standards that support a Web site,” says Claudette DeLenardo, who is director of e-health technologies at Grand River Hospital in Kitchener, Ontario, Canada.



Additional Resources
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In Summary
By the end of 2007, there were nearly 150 million Web sites on the Internet. Currently, it’s expanding at a rate of about 5 percent a month. How can you know the best sites to visit for reliable information? And where should you direct your patients?

  • Look for Web sites that show clear, traceable evidence of the facts displayed and/or are peer-reviewed.

  • Check the Web sites you use for certification by Health on the Net and other accrediting organizations.

  • Assess a Web site’s credibility by checking on its reputation, creators, purpose, funding sources, how current the data is, writing quality, and depth of information.

  •  
    Read More About It
    Before you start surfing the Web, check out these tips:

  • Get more advice on using the Internet by perusing, “Smart Web Surfing.”

  • Are your practice’s computers secure? Find out what you need to know by reading, “Data Security for Non-Techies.”

  • Find out which health Web sites are the most popular by visiting http://www.alexa.com